Quality Assurance
Zambia Performance-Based Incentives Final Study
Prepared for the Quality Assurance Project by Rebecca Furth, Initiatives Inc., 2005
This report documents findings from a 15-month pilot study of the effects of financial and non-financial awards on staff motivation and health facility performance. The study was built around clearly documented and shared health facility performance standards that included HMIS indicators, client satisfaction, health center cleanliness, and rational prescription of antibiotics in addition to process standards such as the development of performance plans and definition of clear actions to address problems. It was conducted in two districts in Zambia, one testing out trophies as non-financial incentives and the other providing cash awards for both high performance and improvement. Study results indicate that non-financial awards are more motivating for staff and influential on facility performance than financial awards, in part because they are not nearly as controversial and financial awards.
(929 KB)
Quality Assurance in the Jordan Primary Health Care System: Best Practices
Developed for the Ministry of Health in Jordan under the Primary Health Care Initiatives (PHCI) Project. Initiatives Inc., 2004.
This booklet presents examples of successful implementation of quality improvement strategies by health center staff at 10 primary health care centers across the Kingdom of Jordan. The descriptions illustrate how systematic problem identification and problem solving can assist health centers to strengthen management, service delivery, performance, and client satisfaction.
This publication has been selected by the World Health Organization (WHO) as a resource for its website and CD for health service managers, MAKER (Managers taking Action based on Knowledge and Effective use of resources to achieve Results). For further information, see the WHO Management for Health Services Delivery website.
(1299 KB)
Jordan: Building Quality in Primary Health Care
Developed for the Ministry of Health in Jordan under the Primary Health Care Initiatives (PHCI) Project by Donna Bjerregaard, Initiatives Inc., 2004.
This short report summarizes the process adopted by the Jordan Ministry of Health to improve the quality of and access to primary and reproductive health care in centers that serve as the initial contact for medical care. The importance of using data for documenting baseline performance and preparing action plans, monitoring processes, and creating an enabling structure for sustainability are all highlighted.
(3833 KB)
Performance Improvement Review (PIR): Resources & Tools for NGOs & CBOs
Developed for the Zambia Integrated Health Programme (ZIHP) by Initiatives Inc., 2004.
The Performance Improvement Review is a self-directed process for improving the effectiveness, sustainability and quality of NGO programs. Guidance and tools for conducting PIRs have been packaged as a CD-ROM to make the materials more accessible to users. The tools address six different program areas: family planning; growth monitoring and promotion; HIV/AIDS (home-based care, VCT, and peer education); malaria; safe motherhood; and water and sanitation, and are designed for use by Program Managers, Donors, District Health Management Teams, and Trainers.
(Available as interactive CD only.)
Standards of Care for Health Centers in Jordan
Developed for the Ministry of Health in Jordan under the Primary Health Care Initiatives (PHCI) Project. Initiatives Inc., 2002.
This six-volume set of standards of care for health centers provides essential and detailed guidance for effective service delivery. Each of the first five volumes addresses a distinct aspect of health center services: health center management, clinical case management, reproductive health, preventive care, and nursing care. The sixth volume offers a comprehensive set of performance checklists, which can be used to facilitate self-assessment and performance review. As a set, the Standards serve as a convenient reference, a guide for service delivery, and a tool to support performance improvement.
This series of documents has been selected by the World Health Organization (WHO) as a resource for its website and CD for health service managers, MAKER (Managers taking Action based on Knowledge and Effective use of resources to achieve Results). For further information, see the WHO Management for Health Services Delivery website.
- Volume 1: Health Center Management
(1422 KB)
- Volume 2: Clinical Case Management
(789 KB) - Volume 3: Reproductive Health
(1446 KB) - Volume 4: Preventive Services
(705 KB) - Volume 5: Nursing Care Services
(833 KB) - Volume 6: Performance Checklists
(782 KB)
Quality Improvement In HIV/AIDS Programs: A Case Study for NGOs/CBOs and their Partners
Developed for the Zambia Integrated Health Programme (ZIHP) by Rebecca Furth, Joyce V. Lyons, and Jenny Huddart, Initiatives Inc., 2002.
Written in an engaging narrative style, this case study outlines the use of the Performance Improvement Review tool in NGO-managed programs. Combining examples from field experience with quality ideals, the case details a fictional NGO's progress through the processes of setting measurable goals, planning program monitoring, building monitoring teams, collecting program data, identifying problems, creating concrete performance improvement plans, and conducting follow-up monitoring reviews.
- Quality Improvement in HIV/AIDS Programs (English)
(307 KB)
- Amélioration de la Qualité dans les Programmes de VIH/SIDA (Français)
(346 KB) - Facilitators' Guide (English Only)
(47 KB)
Integrated Technical Guidelines for Frontline Healthworkers (2nd ed.)
Produced for the Central Board of Health in Zambia, with support from the USAID-funded Zambia Integrated Health Programme, Component 3 (ZIHP-Systems). Initiatives Inc. and ZIHP, July 2002.
The Integrated Technical Guidelines (ITGs) outline key interventions for each of the technical areas of the Basic Health Care Package (BHCP), as well as the minimum standards of performance expected at community, health post, and health centre levels. These guidelines are intended to enhance frontline healthworkers' knowledge about the most important health problems in Zambia, and cost-effective interventions to tackle these problems. Use of these guidelines should improve the ability of frontline health workers to promote health and prevent illness, including proper case management and referrals, and thereby contribute to the attainment of the ultimate goal of "Better Health for all Zambians."
(5635 KB)
Universal Precautions Guidelines for Primary Health Care Centers in Indonesia
Developed for the Universal Precautions and Training Project, Surabaya, Indonesia, by Initiatives Inc., 2000.
This document, designed for all levels of clinic staff, contains universal precaution guidelines for proper infection prevention procedures. The guidelines and curriculum stress behavior change and the importance of supervision in ensuring compliance with the guidelines.
(222 KB)
A Performance Improvement Review of the Nialama Classified Forest Co-Management Program
Julie Fischer and Rebecca Furth. Winrock International: Projet Elargi de Gestion des Ressources Naturelles. Report No. 77, 2000.
This report documents the first Performance Improvement Review (PIR) process conducted in the Nialama Forest Co-Management Program in October 2001. The report outlines the background of the forest co-mangement program in Guinea; the rationale for and development of the PIR process for co-management; problems identified and agreed actions determined during the first review; and lessons learned.
- PIR of the Nialama Classified Forest Co-Management Program (main report)
(57 KB) - Appendices
(77 KB)
The Performance Improvement Review Package (PIR): A Quality Assurance Tool for Community Based Programs
Developed for the SEATS Project by Joyce V. Lyons, Rebecca Furth, Donna S. Bjerregaard, and Catherine C. Mukwakwa, Initiatives Inc., 1999.
A set of quality assurance tools to support PVOs/NGOs as they integrate family planning and reproductive health activities into their existing portfolios. Assists community-based programs to conduct self-directed program reviews, identify key problems and develop corrective action plans. Provides an effective monitoring and evaluation system with data for tracking progress.
(1107 KB)